Invasive Ductal Carcinoma Stage 2 - Treatment Plan?

Posted by journey99 @journey99, Feb 18, 2023

I am newly diagnosed with IDC Stage 2, 1.3 cm in size. Estrogen Receptor positive, Progesterone positive (1-10%) so not positive enough I have been told, HER2 negative. Ki-67 15%.
I meet with the oncologist, surgeon & radiologist next week. Looking for anyone that has had a similar diagnosis that would share what they had for a treatment plan. Surgery then chemo? Chemo than surgery has been mentioned. What questions I should ask the team? What are things I should consider? Any advice is helpful. I am being told radiation is for sure since lymph nodes are involved. Thank you in advance for sharing experiences and information.

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@anjalima

I agree that each journey is quite unique. Interesting that Anastrozole shrunk the diseased areas by 1/3! I’m then assuming that the ONCOTYPE was done on biopsy tissue vs. surgically removed tissue.

I also had Er+ 99%, HER2- , 2 node + with favorable ONCOTYPE. I had a unilateral mastectomy. Opted out of radiation ( breast surgeons did not recommend) and based on information gleaned from many many hours of research on the pros and cons… including the final piece; a clinical trial TAILOR RT. This trial which is to radiation what chemo was to TAILOR DX ( which established the ONCOTYPE and benefit OR NOT for chemo) . From a BC profile I fit the trial… one arm of which was aromatase inhibitor only and other arm was AI plus standard radiation. At phase 3 they pretty much understood that AI alone was not a inferior treatment option.

A question still lingers for me however … as KI-67 was 22… just over low border. Verzenio has come up. What was your KI 67 and how are you managing on the Verzenio?

Blessings on the path 🌸

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I am always amazed to hear medical plans and how they differ from one person/set of circumstances to another.

My tumor was fairly large and had gone through the dermis. Two lymph nodes were palpable. My oncotype was done on my biopsy sample. Because of my lymph node involvement, radiation was a given. When I had my surgery, I had a complete lymph node dissection. The sentinel node was positive and nine of the other 19 removed were positive also. So 10 of the 20 were positive.

My surgeon, oncologist, and radiology oncologist never wavered in my need for radiation. They explained that the surgery removed the tumor and lymph nodes and radiation would kill any remaining traces in the tumor bed, other tissue, and incision sites. I had 38 regular and 5 boosts (incision site specific) treatments.

My KI-67 score was 67. I thought it was a trick of my eyes when I saw it. My tumor size, number of lymph nodes involved, plus my KI-67 score put me in the high reoccurrence area. The anastrozole with the addition of Verzenio were highly recommended by my oncologist.

I had surgery in May, radiation during June and July, and started Verzenio in August. It was a rough time, and Verzenio has been difficult. At the beginning, diarrhea was overwhelming, but that has become more manageable. I went into this with an open mind and said I would do whatever I needed in order to rid myself of cancer. My care team is outstanding, and I value their expertise. My oncologist is wonderful. She has been truthful about what is the best medical approach, but she also says that my “quality of life” is also important and will honor any decision I make.

My way of handling bumps in the road is to push myself to do more, to walk daily even though it may not be too far on some days, and make sure I do something worthwhile. The more I push, the more positive I feel. I have gone to PT to get range of motion and strength. I have bought special shampoo for hair loss and that has helped. I am eating a healthy diet and pushing myself daily. Lack of energy is still my main concern. However, I know that I am doing everything possible to get healthy.

It would be wonderful if there was a “one size fits all” plan, but everyone’s situation is so different. It all comes down to each person making the best decision for his/her life. I read so many people wanting advice on procedures and medicines. I have learned to value the advice of my care team, do my own research, and listen to the opinion of others. However, ultimately I need to make a decision that is best for me and my circumstances. Good luck to you and the decisions you make on your journey.

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@kammcn

I am always amazed to hear medical plans and how they differ from one person/set of circumstances to another.

My tumor was fairly large and had gone through the dermis. Two lymph nodes were palpable. My oncotype was done on my biopsy sample. Because of my lymph node involvement, radiation was a given. When I had my surgery, I had a complete lymph node dissection. The sentinel node was positive and nine of the other 19 removed were positive also. So 10 of the 20 were positive.

My surgeon, oncologist, and radiology oncologist never wavered in my need for radiation. They explained that the surgery removed the tumor and lymph nodes and radiation would kill any remaining traces in the tumor bed, other tissue, and incision sites. I had 38 regular and 5 boosts (incision site specific) treatments.

My KI-67 score was 67. I thought it was a trick of my eyes when I saw it. My tumor size, number of lymph nodes involved, plus my KI-67 score put me in the high reoccurrence area. The anastrozole with the addition of Verzenio were highly recommended by my oncologist.

I had surgery in May, radiation during June and July, and started Verzenio in August. It was a rough time, and Verzenio has been difficult. At the beginning, diarrhea was overwhelming, but that has become more manageable. I went into this with an open mind and said I would do whatever I needed in order to rid myself of cancer. My care team is outstanding, and I value their expertise. My oncologist is wonderful. She has been truthful about what is the best medical approach, but she also says that my “quality of life” is also important and will honor any decision I make.

My way of handling bumps in the road is to push myself to do more, to walk daily even though it may not be too far on some days, and make sure I do something worthwhile. The more I push, the more positive I feel. I have gone to PT to get range of motion and strength. I have bought special shampoo for hair loss and that has helped. I am eating a healthy diet and pushing myself daily. Lack of energy is still my main concern. However, I know that I am doing everything possible to get healthy.

It would be wonderful if there was a “one size fits all” plan, but everyone’s situation is so different. It all comes down to each person making the best decision for his/her life. I read so many people wanting advice on procedures and medicines. I have learned to value the advice of my care team, do my own research, and listen to the opinion of others. However, ultimately I need to make a decision that is best for me and my circumstances. Good luck to you and the decisions you make on your journey.

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Thank you for your response. Your attitude is positive and upbeat and will take you through this unwanted journey (we are traveling) with good vibes. Yes. Everyone is unique and each course of action is a decision arrived at through medical expertise and one’s own research and what is possible in any given circumstance. We do what we can. I’m happy to hear that you are doing better on Verzenio. We are so incredibly lucky to have these drugs in our arsenal these days! My KI-67 is 20 and 22 ( two foci) so I’m just 2 points over border from low so it is being discussed. Also signing up with Signatura ( new blood biopsy concept) for early early detection of recurrence. So many new tools and so much to know about. Blessings on the path. 🌸

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@kammcn

I am always amazed to hear medical plans and how they differ from one person/set of circumstances to another.

My tumor was fairly large and had gone through the dermis. Two lymph nodes were palpable. My oncotype was done on my biopsy sample. Because of my lymph node involvement, radiation was a given. When I had my surgery, I had a complete lymph node dissection. The sentinel node was positive and nine of the other 19 removed were positive also. So 10 of the 20 were positive.

My surgeon, oncologist, and radiology oncologist never wavered in my need for radiation. They explained that the surgery removed the tumor and lymph nodes and radiation would kill any remaining traces in the tumor bed, other tissue, and incision sites. I had 38 regular and 5 boosts (incision site specific) treatments.

My KI-67 score was 67. I thought it was a trick of my eyes when I saw it. My tumor size, number of lymph nodes involved, plus my KI-67 score put me in the high reoccurrence area. The anastrozole with the addition of Verzenio were highly recommended by my oncologist.

I had surgery in May, radiation during June and July, and started Verzenio in August. It was a rough time, and Verzenio has been difficult. At the beginning, diarrhea was overwhelming, but that has become more manageable. I went into this with an open mind and said I would do whatever I needed in order to rid myself of cancer. My care team is outstanding, and I value their expertise. My oncologist is wonderful. She has been truthful about what is the best medical approach, but she also says that my “quality of life” is also important and will honor any decision I make.

My way of handling bumps in the road is to push myself to do more, to walk daily even though it may not be too far on some days, and make sure I do something worthwhile. The more I push, the more positive I feel. I have gone to PT to get range of motion and strength. I have bought special shampoo for hair loss and that has helped. I am eating a healthy diet and pushing myself daily. Lack of energy is still my main concern. However, I know that I am doing everything possible to get healthy.

It would be wonderful if there was a “one size fits all” plan, but everyone’s situation is so different. It all comes down to each person making the best decision for his/her life. I read so many people wanting advice on procedures and medicines. I have learned to value the advice of my care team, do my own research, and listen to the opinion of others. However, ultimately I need to make a decision that is best for me and my circumstances. Good luck to you and the decisions you make on your journey.

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Would be interested in learning about your shampoo if it’s helping with hair thinning. This has been one of my AI side effects. 🌸

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I actually read about this shampoo on this site. I order it from Amazon. It is Nioxin System 1 Cleanser shampoo for natural hair and light thinning with Nioxin System 1 Scalp Therapy conditioner for natural hair with light thinning. At first I bought the 3 pack shampoo, conditioner, and scalp massage, but I have never really used the message portion. There are different systems for colored treated hair, light thinning, or progressed thinning.

I have continued to use this one from the beginning. It seems like I have lots of hair in my brushes, etc, but my hair has remained fairly thick and full. I didn't reorder this once for a month or so, and I noticed a recognizable difference in the texture of my hair. I hope it helps you.

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I had same diagnosis HR+ HEW- stage 1(2016). My cancer hadn’t spread to lymph nodes so my option was Lumpectomy. I couldn’t imagine a mastectomy it seemed too drastic and be hard accepting loss of my breast. By all means if that was my only choice, I certainly would have done it. To this day I’m happy with my choice, I’ve had no problems and healed quickly. “To each their own” go with your instincts and whatever choice you make it will yours to make and what’s the best course to follow. Mastectomy surely removes all of your breast tissue eliminating odds of re-occurrence , it’s just a matter of what you’re exceptive of.
Best wishes 🫶👍

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@anjalima

Would be interested in learning about your shampoo if it’s helping with hair thinning. This has been one of my AI side effects. 🌸

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I’ve been using Biotin shampoo and Keranique conditioner Both are made for fine hair as well as promoting growth. It’s a slow process but gradually I feel my hair has gotten thicker. Worth the try too👍

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@rosy54

I’ve been using Biotin shampoo and Keranique conditioner Both are made for fine hair as well as promoting growth. It’s a slow process but gradually I feel my hair has gotten thicker. Worth the try too👍

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Thank you. Might you post the brand of the biotin shampoo?

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@kammcn

I actually read about this shampoo on this site. I order it from Amazon. It is Nioxin System 1 Cleanser shampoo for natural hair and light thinning with Nioxin System 1 Scalp Therapy conditioner for natural hair with light thinning. At first I bought the 3 pack shampoo, conditioner, and scalp massage, but I have never really used the message portion. There are different systems for colored treated hair, light thinning, or progressed thinning.

I have continued to use this one from the beginning. It seems like I have lots of hair in my brushes, etc, but my hair has remained fairly thick and full. I didn't reorder this once for a month or so, and I noticed a recognizable difference in the texture of my hair. I hope it helps you.

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Thank you. I’ll definitely look into this. 🌸

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@anjalima

Thank you. Might you post the brand of the biotin shampoo?

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Hope picture will post

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@rosy54

Hope picture will post

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Hope picture uploads

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